Individual provider Active NPI

Abbie Elizabeth Martin, NP

  • Family Nurse Practitioner
  • Lee'S Summit, MO
National Provider Identifier
1376991091
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2022031560 Issued in MO
Practice address
455 NW Murray Rd
Lee'S Summit, MO 64081
Phone
(913) 218-0162
Fax
(913) 301-5506
NPI assigned
Jun 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-77259 KS
Family Nurse Practitioner 363LF0000X 2022031560 MO Primary

Addresses

Primary practice location

455 NW Murray Rd
Lee'S Summit, MO 64081

Mailing address

14253 Metcalf Ave
Overland Park, KS 66223-3367
Phone (913) 218-0162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-77259KSMDFamily Nurse Practitioner
2022031560MOMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1376991091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14253 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233367",
            "telephone_number": "913-218-0162",
            "fax_number": "913-301-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 NW MURRAY RD",
            "city": "LEE'S SUMMIT",
            "state": "MO",
            "postal_code": "64081",
            "telephone_number": "913-218-0162",
            "fax_number": "913-301-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ABBIE",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-77259",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2022031560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee'S Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.